725
Editorials
Vol. 112, No.6
My confidant and friend through these years at THE JOURNAL was David Shoch, who succeeded Herbert Haessler as editor of the abstract section in 1963, shortly after I was named associate editor. We became friends when I joined the staff at Northwestern Medical School where David was, at that time, a senior medical student and a frequent visitor to the Department of Biochemistry where he had received the Ph.D. degree. He turned to ophthalmology at the School of Aviation Medicine, then headed by General Victor A. Byrnes. On his return from military service, David disappointed a host of biochemists and internists at the Northwestern Hospitals when he enrolled in the graduate course in ophthalmology, which was initiated by Dr. Vail to assist military veterans. In 1953 Dr. Vail discontinued surgical ophthalmology after severe myocardial infarction, and Dr. Shoch became immediately involved in a large, demanding, international surgical practice with influential and prominent patients. In more recent years, Drs. H. Stanley Thompson, Ronald Burde, Thomas Aaberg, and Michael Kass have met at the JOURNAL offices each month to consult concerning editorial matters. Dr. Thompson took over editorial direction of the book review section and more recently Dr. Kass succeeded Dr. Shoch as editor of the abstract section. Mary L. Borysewicz joined THE JOURNAL in February 1973 as managing editor and has been in charge of all aspects of JOURNAL operation: subscriptions, advertising, marketing, editorial processing and production. As an independent publisher, The Ophthalmic Publishing Company manages all business and editorial matters without outside assistance. It is mainly the result of the efforts of Ms. Borysewicz and her staff that THE JOURNAL has become the major international publication in ophthalmology.
Since 1965, publication of THE JOURNAL has become far more complex. Circulation has doubled. The number of subscribers residing outside of the United States has exploded. English is not the primary language of many of the subscribers, and we make a major effort to provide text that all can understand. THE JOURNAL changed slowly with the reduction in the length of the abstract section and the loss of the loyal collaborators who translated the abstracts to English from a host of languages. (Derrick Vail's first association with THE JOURNAL was as a collaborator to translate articles originally published in French.) The section on Notes, Cases, and Instruments has been replaced by the even more popular Letters to THE JOURNAL section. The News Items section is far more abbreviated. In January 1985, THE JOURNAL page dimensions were increased to their current size. THE JOURNAL nonetheless continues a two-column format, and Edward Jackson would easily recognize the publication he fathered in the third series. The past three decades have been a golden era for me. There have been remarkable advances in nearly every phase of ophthalmology and in the practice of medicine. It has been a privilege to know so many of the leaders in ophthalmology throughout the world. I wish my successor an equally happy journey.
References 1. Newell, F. W.: Ophthalmology and the future. Arch. Ophthalmol. 74:448, 1965. 2. Ingelfinger, F. J.: Peer review in biomedical publications. Am. J. Med. 56:686, 1974.
Preoperative Medical Examinations for Patients Undergoing Ophthalmic Surgery George B. Bartley and Bradly J. Narr The setting for ophthalmic surgery varies from hospital operating rooms to ambulatory surgical centers to physicians' offices. The type of anesthesia likewise broadly ranges from general anesthesia for vitreoretinal, orbital, or pediatric surgery; to local anesthesia (often with sedation) for most anterior segment operations;
to topical anesthesia for some minor procedures. Most ophthalmic surgery is elective and most patients are relatively healthy (Classes I or II) at the time of the operation, as defined by the American Society of Anesthesiologists (Table 1). Preoperative medical examinations and laboratory tests are often performed perfuncto-
726
AMERICAN JOURNAL OF OPHTHALMOLOGY
TABLE 1 PHYSICAL STATUS CLASSIFICATION ESTABLISHED BY AMERICAN SOCIETY OF ANESTHESIOLOGISTS'
December, 1991
TABLE 2 MINIMAL PREOPERATIVE TEST REQUIREMENTS AT THE MAYO CLINIC'
CLASS
DESCRIPTION
AGE (YRS)
TESTS REQUIRED!
I II III
Healthy patient Mild systemic disease, no functional limitation Severe systemic disease, definite functional limitation Severe systemic disease that is a constant threat to life Moribund patient unlikely to survive 24 hours with or without operation
Editorials
Vol. 112, No.6
My confidant and friend through these years at THE JOURNAL was David Shoch, who succeeded Herbert Haessler as editor of the abstract section in 1963, shortly after I was named associate editor. We became friends when I joined the staff at Northwestern Medical School where David was, at that time, a senior medical student and a frequent visitor to the Department of Biochemistry where he had received the Ph.D. degree. He turned to ophthalmology at the School of Aviation Medicine, then headed by General Victor A. Byrnes. On his return from military service, David disappointed a host of biochemists and internists at the Northwestern Hospitals when he enrolled in the graduate course in ophthalmology, which was initiated by Dr. Vail to assist military veterans. In 1953 Dr. Vail discontinued surgical ophthalmology after severe myocardial infarction, and Dr. Shoch became immediately involved in a large, demanding, international surgical practice with influential and prominent patients. In more recent years, Drs. H. Stanley Thompson, Ronald Burde, Thomas Aaberg, and Michael Kass have met at the JOURNAL offices each month to consult concerning editorial matters. Dr. Thompson took over editorial direction of the book review section and more recently Dr. Kass succeeded Dr. Shoch as editor of the abstract section. Mary L. Borysewicz joined THE JOURNAL in February 1973 as managing editor and has been in charge of all aspects of JOURNAL operation: subscriptions, advertising, marketing, editorial processing and production. As an independent publisher, The Ophthalmic Publishing Company manages all business and editorial matters without outside assistance. It is mainly the result of the efforts of Ms. Borysewicz and her staff that THE JOURNAL has become the major international publication in ophthalmology.
Since 1965, publication of THE JOURNAL has become far more complex. Circulation has doubled. The number of subscribers residing outside of the United States has exploded. English is not the primary language of many of the subscribers, and we make a major effort to provide text that all can understand. THE JOURNAL changed slowly with the reduction in the length of the abstract section and the loss of the loyal collaborators who translated the abstracts to English from a host of languages. (Derrick Vail's first association with THE JOURNAL was as a collaborator to translate articles originally published in French.) The section on Notes, Cases, and Instruments has been replaced by the even more popular Letters to THE JOURNAL section. The News Items section is far more abbreviated. In January 1985, THE JOURNAL page dimensions were increased to their current size. THE JOURNAL nonetheless continues a two-column format, and Edward Jackson would easily recognize the publication he fathered in the third series. The past three decades have been a golden era for me. There have been remarkable advances in nearly every phase of ophthalmology and in the practice of medicine. It has been a privilege to know so many of the leaders in ophthalmology throughout the world. I wish my successor an equally happy journey.
References 1. Newell, F. W.: Ophthalmology and the future. Arch. Ophthalmol. 74:448, 1965. 2. Ingelfinger, F. J.: Peer review in biomedical publications. Am. J. Med. 56:686, 1974.
Preoperative Medical Examinations for Patients Undergoing Ophthalmic Surgery George B. Bartley and Bradly J. Narr The setting for ophthalmic surgery varies from hospital operating rooms to ambulatory surgical centers to physicians' offices. The type of anesthesia likewise broadly ranges from general anesthesia for vitreoretinal, orbital, or pediatric surgery; to local anesthesia (often with sedation) for most anterior segment operations;
to topical anesthesia for some minor procedures. Most ophthalmic surgery is elective and most patients are relatively healthy (Classes I or II) at the time of the operation, as defined by the American Society of Anesthesiologists (Table 1). Preoperative medical examinations and laboratory tests are often performed perfuncto-
726
AMERICAN JOURNAL OF OPHTHALMOLOGY
TABLE 1 PHYSICAL STATUS CLASSIFICATION ESTABLISHED BY AMERICAN SOCIETY OF ANESTHESIOLOGISTS'
December, 1991
TABLE 2 MINIMAL PREOPERATIVE TEST REQUIREMENTS AT THE MAYO CLINIC'
CLASS
DESCRIPTION
AGE (YRS)
TESTS REQUIRED!
I II III
Healthy patient Mild systemic disease, no functional limitation Severe systemic disease, definite functional limitation Severe systemic disease that is a constant threat to life Moribund patient unlikely to survive 24 hours with or without operation
